A 2009 film, The Story of Lewis Blackman, was shown at the opening of the Robert Wood Johnson Foundation’s (RWJF’s) Quality and Safety Education for Nurses (QSEN) National Forum in Denver, Colorado this month. The tragic story of a young life lost was a stark reminder about the importance of QSEN’s patient safety and quality of care competencies, to which nursing faculty are now teaching at universities and community colleges across the United States as well as in Canada and Sweden.
Rosemary Gibson, M.Sc., an author and health care thought-leader, showed the film to more than 300 educators, textbook writers and publishers at the Forum’s opening session. Gibson is a former senior program officer at RWJF and the author of Wall of Silence: The Untold Story of the Medical Mistakes that Kill and Injure Millions of Americans and The Treatment Trap: How the Overuse of Health Care is Wrecking Your Health and What You Can Do to Prevent It.
QSEN has produced a series of short videos about Blackman’s case that feature interviews with his mother, Helen Haskell. Designed as teaching tools, they are available on QSEN’s Web Site along with discussion questions for nursing students.
“It’s not a model. It’s a transformation,” Gibson said about QSEN’s work to promote quality and safety competencies in new graduates of nursing programs. Identified as crucial for health professionals by the Institute of Medicine, faculty in QSEN pilot schools began working in 2007 to corporate these competencies into curricula at 15 schools of nursing. Today, they are becoming more and more widely used.
The self-described “QSENistas” who attended the Forum participated in sessions addressing: ways to include the competencies across school of nursing curricula for students earning A.D.s, B.S.N.s and advanced degrees; integrating the competencies into classroom and clinical teaching; simulations using the web platform Second Life; and much more.
During sessions, breaks and meals, speakers and participants discussed the ways QSEN has changed courses, approaches to teaching and student thinking. Many speakers noted that students who learn the QSEN competencies tend to think about the ways systems work and how to improve them—and refuse to accept the answer: “That’s how we’ve always done it.”
QSEN has helped students recognize that quality improvement is an important part of their work as nurses, speakers said. They are learning to regularly search for ways to improve quality of care and patient safety, and to rigorously evaluate recommendations for such improvements. This kind of approach was rarely emphasized in nursing education in the past. QSEN is changing the way nursing students at many institutions see their roles as part of health care teams.
Moving from Curricula to Certification
In closing remarks, Linda Cronenwett, Ph.D, R.N., F.A.A.N., principal investigator for QSEN, and distinguished professor and former dean at The University of North Carolina at Chapel Hill School of Nursing, summarized how far QSEN has come since it began in 2005.
The QSEN website attracts hundreds of visitors per day and QSEN publications, appearing first in 2007, have now been cited by more than 90 authors, she said. Several nursing education associations—including the American Association of Colleges of Nursing, the National League of Nursing and the National Organization of Nurse Practitioner Faculties—are working to promote or require quality and safety competency development as essentials for accreditation standards. Publishers and writers are including the competencies in nursing textbooks.
“Another exciting development,” Cronenwett said, “is the inclusion of QSEN competencies in the National Council of State Boards of Nursing proposals for transition to practice residencies. Some day, new nurses may not be relicensed after one year of practice without demonstrating this competency development. Certification is the next frontier.”